NPIMap

Organization Active NPI

Polson SNF Operations, LLC

Doing business as Polson Health & Rehabilitation Center

  • Skilled Nursing Facility
  • Polson, MT
National Provider Identifier
1013621473
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
POLSON SNF OPERATIONS, LLC
Doing business as
Polson Health & Rehabilitation Center
Practice address
9 14TH Ave W
Polson, MT 59860-5321
Phone
(406) 883-4378
Fax
(732) 523-5312
NPI assigned
Jan 10, 2023
Last updated
Jan 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yitzchok Yenowitz
Title
Authorized Official
Phone
(347) 693-4239

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU
Clinic/Center 261Q00000X NU
Hearing and Speech Clinic/Center 261QH0700X NU
Physical Therapy Clinic/Center 261QP2000X NU
Occupational Medicine Clinic/Center 261QX0100X NU
Skilled Nursing Facility 314000000X NU Primary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Registered Respiratory Therapist 227900000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

9 14TH Ave W
Polson, MT 59860-5321

Mailing address

4601 NE 77TH Ave Ste 300
Vancouver, WA 98662-6736
Phone (360) 837-0400

Other names 1

  • Polson Health & Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240207000515 MT Part A Provider - Skilled Nursing Facility 2163865171 Practice locations: Polson, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013621473. Details of each certification follow.

Skilled nursing facility certification: CCN 275049

Legal name
POLSON SNF OPERATIONS LLC
Doing business as
POLSON HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1979
Last certification
Sep 12, 2024
Beds
70
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Empres Operated by Evergreen, LLC
Organization structure
LLCProprietary
Enrollment address
9 14TH Ave W
Polson, MT 59860-5321
Nursing home name
POLSON HEALTH & REHABILITATION CENTER
Affiliated entity
EVERGREEN HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Polson Health & Rehabilitation CenterCCN 275049 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7051.5 residents per day on average
Chain
Evergreen Healthcare Group44 facilities in the chain
Penalties (3 years)
1Fines totaling $17,404

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Organization, Hunt Valley, MD LLC Adp of the SNF Aug 31, 2023
Witzcorp PNW 12 LLC Organization, Lakewood, NJ LLC, Owned by another organization or individual Indirect Ownership Interest Aug 31, 2023 25%
Couve Healthcare Consulting LLC Organization, Vancouver, WA LLC Operational/Managerial Control Aug 31, 2023
Adp of the SNF Apr 10, 2025
CH PNW 12 Holdings LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Aug 31, 2023 66.5%
Individual Indirect Ownership Interest Aug 31, 2023 3%
Polson SNF Operations LLC Organization, Polson, MT LLC Operational/Managerial Control Aug 31, 2023
Adp of the SNF May 20, 2025
Direct Ownership Interest Aug 31, 2023
PNW 12 Opco Management LLC Organization, Lakewood, NJ LLC, Management services company, For-profit Operational/Managerial Control Aug 31, 2023
Couve Financial Services LLC Organization, Vancouver, WA LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Aug 31, 2023
Adp of the SNF Apr 9, 2025
Organization, Lakewood, NJ Indirect Ownership Interest Aug 31, 2023 2.25%
Individual Adp of the SNF Aug 31, 2023
Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Aug 31, 2023 1%
Joann Ensuncho Individual Operational/Managerial Control Aug 31, 2023
Adp of the SNF Aug 31, 2023
Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Aug 31, 2023 3%
James Hohn Individual Managing Control - Governing BodyDivisional Director of Clinical Ops Aug 31, 2023
Adp of the SNF Aug 31, 2023
Organization, Lakewood, NJ Indirect Ownership Interest Aug 31, 2023 2.25%
Yitzchok Yenowitz Individual Corporate OfficerChief Executive Officer, Ao Aug 31, 2023
Operational/Managerial Control Aug 31, 2023
Adp of the SNF Aug 31, 2023
Indirect Ownership Interest Aug 31, 2023 25%
Yisroel E Herzka Individual Indirect Ownership Interest Aug 31, 2023 66.5%
PNW 12 Opco Management LLC Organization, Lakewood, NJ LLC Operational/Managerial Control Aug 31, 2023
Adp of the SNF Apr 10, 2025
Thomas Wright Individual Operational/Managerial Control Aug 31, 2023
Adp of the SNF Aug 31, 2023
PNW 12 SNF Consulting LLC Organization, Lakewood, NJ LLC Operational/Managerial Control Aug 31, 2023
Adp of the SNF Apr 10, 2025
Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Aug 31, 2023 2.25%
Shimon Spielman Individual Corporate OfficerChief Financial Officer, Ao Aug 31, 2023
Operational/Managerial Control Aug 31, 2023
Adp of the SNF Aug 31, 2023
Individual Indirect Ownership Interest Aug 31, 2023 1%
Donald Randolph Cheeks Individual Operational/Managerial Control Aug 31, 2023
Managing Control - Governing BodyRegional Director of Operations Aug 31, 2023
Adp of the SNF Aug 31, 2023
Indirect Ownership Interest Aug 31, 2023
Pacific Northwest 12 Leased Operations Holdings LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Direct Ownership Interest Aug 31, 2023 100%
Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Aug 31, 2023 2.25%

Facilities with the same owner 51

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 51

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1013621473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626736",
            "telephone_number": "360-837-0400",
            "fax_number": "360-967-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 14TH AVE W",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605321",
            "telephone_number": "406-883-4378",
            "fax_number": "732-523-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLSON SNF OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-10",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "YENOWITZ",
        "authorized_official_first_name": "YITZCHOK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "347-693-4239"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polson Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.